Evidence-Based Risk Communication in Annals of Internal Medicine

Dr. Daniella Zipkin, an Associate Professor of Medicine at Duke University Medical Center, is one of 14 authors who contributed to “Evidence-Based Risk Communication: A Systematic Review,” published in Annals of Internal Medicine in August 2014.

“Evidence-Based Risk Communication: A Systematic Review” reviewed 84 articles focusing on 91 studies that assessed different methods of communicating risks and benefits to patients regarding their health care options. The goal of the review was to identify the communication methods that maximize patient understanding, which is a component of evidence-based medicine (EBM).

The systematic review concluded that visual aids, such as bar graphs or displays of icons, are capable of increasing patient understanding and satisfaction. Other presentation methods reduced patient understanding, such as “number needed to treat” statistics, which are commonly used in health care to express the average number of people who need to receive treatment in order to prevent an additional negative outcome.

In addition to her published research, Dr. Daniella Zipkin also promotes evidence-based medicine in her work as a member of the Evidence-Based Medicine Task Force within the Society of General Internal Medicine.

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Utah’s Snow is Among the Greatest on Earth

A graduate of the University of California, San Francisco School of Medicine, Daniella Zipkin, MD, is currently an assistant professor at the Duke University Medical Center, where she teaches a curriculum in evidence-based medicine. In her personal life, Dr. Daniella Zipkin is an avid snowboarder with a special affinity for the powdery snow of Utah’s mountains.

Marketed as the greatest on earth, Utah’s snow is well known for being dry and light, which produces the high-quality powder that attracts skiers from around the world. In addition, Utah receives many significant snow storms each year, which increases the number of powder days and often leads to long seasons of very enjoyable skiing. In fact, Utah’s snow is so fun to ski that in 2010 it took seven of Ski Magazine’s top 10 rankings for snow.

The reason for Utah’s excellent skiing is largely the result of its geography. Because most of the state is considered desert, it is quite arid, which saps its snow of much of its moisture and allows it to remain light and fluffy. Also, the Great Salt Lake in northern Utah is so large that it creates a lake effect on regional snow storms and leads to huge accumulations in the surrounding mountains. These facts, combined with Utah’s large mountain peaks, make the state’s resorts a world-class destination for ski and snow enthusiasts.

Medical Education Community Lacks Proper Training on Physician-Pharmaceutical Company Interactions

Each year, pharmaceutical companies spend billions of dollars on marketing and outreach, and an overwhelming majority of those funds support promoting drugs to physicians and other medical professionals. Studies and literature show that these promotional activities effectively influence doctors some to most of the time, including affecting their prescribing actions and their decisions in stocking their pharmacies.

However, interactions between pharmaceutical companies and physicians often begin before the latter population even finishes medical school. Drug manufacturers sponsor meals and conferences for doctors-in-training, provide them with books and gifts, and even back scientific meetings that they attend. In one study, medical students reported an average of 10 to 11 contacts with pharmaceutical representatives each month. Plus, many medical school program directors allow these interactions to take place by providing opportunities for drug reps to give presentations to and meet with students. At the same time, the majority of physician trainees report being underprepared for such meetings and interactions and not fully aware of the guidelines governing them. According to one study, only about 23 percent of medical residents reported reading such guidelines.

About the Author:
Daniella Zipkin, M.D., researched medical student-pharmaceutical company relationships while working as an Attending Physician in the Department of Internal Medicine at the California Pacific Medical Center in San Francisco.

Tips for Balancing Work and Parenting

by Dr. Daniella Zipkin

As an Assistant Professor of Medicine at the Duke University Medical Center, and mother of two toddlers, Dr. Daniella Zipkin juggles her time between work and family. Here, Dr. Zipkin offers tips based on her ability to balance these two important aspects of her life:

1. Establish consistent routines. Regular morning and bedtime routines offer a lot of stability in the lives of toddlers and small children, since they will know what to expect. If you are lucky enough to have a work schedule with regular hours, make sure you are a part of these rituals each day, to the extent that you’re able. If your shifts vary or you often work late or overnight, set clear expectations ahead of time, and consider creating a calendar system once your child is old enough to understand one. Giving the child some control by letting them look ahead at what’s coming should ease the turbulence for them.

2. Streamline mealtime. Prepare simple foods you can eat for a few nights, or try cooking on weekends and freezing foods for the week to come. Sit down each evening for a family meal so everyone can stay connected.

3. Turn off the TV, computer, and video games. These activities waste significant amounts of time you could be spending together as a family. Instead, enjoy one another’s company through group activities such as reading together, playing games, or doing puzzles.

4. Take the pressure off! It’s natural to feel some pull towards “making it up to the kids” when you do have time together, by planning special events or buying gifts. Remember that, to your toddlers and small children, the best thing they can have is time with you. Take the pressure off of your free time together, don’t worry about planning too much, and enjoy time at home, outside, or parks nearby.

5. Help your young child or toddler feel special by paying attention to their activities. Encourage them to do more of what they enjoy, and be sure to keep mementos of your time together with you when you work – whether that’s a drawing they have made, or photos you have taken together.